TTC – Charting Your Sex Hormones with Temperature

When trying to conceive, here at Fertility Help Hub, we know first-hand what a minefield charting your cycle can be. Endless months of not quite knowing when your exact ‘peak’ ovulation time is and feeling anxious and pressurised about charting correctly. It can become obsessive. For example, I (Eloise) used to assume and worry that I had a short leuteal phase, without having any science or knowledge to back that up! Months later, it turned out I didn’t. That’s why we thought it would be useful to share fertility tracker ‘iFertracker’s’ guidance and expertise on how to chart accurately and easily. Read all about charting below and benefit from 10% off their trackers with code FHH10

Introducing iFertracker’s Guide – Charting Your Sex Hormones Through Temperature…

@ifertracker | www.ifertracker.com

You’re about to become an absolute EXPERT in basal body temperature (BBT) tracking! Basal body temperature tracking is an incredible tool for tracking ovulation and learning about your fertility. By simply monitoring your temperature on a daily basis you can find out when you are most fertile and learn all about your hormones. The iFertracker is a wearable thermometer that makes BBT tracking easy. It’s simple to use, it’s effective, and it will change the way you understand your body. Dig in and read all about how you can use this smart thermometer to hack your hormones and get pregnant naturally!

BASAL BODY TEMPERATURE (BBT)

This is the lowest temperature your body produces, which occurs two hours before you wake up. Sleeping is the best time to measure the thermogenic effect of sex hormones; once you wake up your thyroid gland takes over your body temperature and we can’t measure the effects of estrogen and progesterone anymore. When you take your temperature in the middle of the day it is a reflection of your thyroid function and not your sex hormones. Your BBT, which can ONLY be measured while you are sleeping, is a reflection of your sex hormones.

THERMOGENIC EFFECT

This is the effect that hormones have on basal body temperature. Hormones can increase and decrease your body temperature. But how do you measure your temperature whilst sleeping? You’ll find out soon!

HORMONES & THE PHASES OF YOUR MENSTRUAL CYCLE – What Your Temperature Can Tell You

The “Normal” Cycle –

• The ideal cycle for conception is 28 days long, with ovulation on cycle day 14

• Cycles ranging from 26-35 days are usually deemed healthy for conception, with ovulation ranging from cycle day 12-18

• Anything outside of this range is less optimal, and may be an area to focus on. It may even be worth a chat with your doctor to see what they recommend.

• Another important factor to consider when evaluating your cycle length is how much it may vary from cycle to cycle. In other words, take your longest and shortest cycle from the last 3-6 months and subtract them from one another. If your longest cycle was >5 days different from your shortest, that would definitely be an indication of irregularity.

• A normal cycle has 4 phases – Menstruation, Follicular (pre-ovulation), Ovulation or ovulatory phase, and Luteal (post-ovulation). The first day of your period is the first day of your cycle, making the last day of your luteal phase the last day of your cycle

• Quick note: Keeping a log of cycle lengths & symptoms and tracking hormonal fluctuations with temperature are the best first steps for combatting irregularities.

ESTROGEN &FSH – The Follicular Phase

The follicular phase takes place during the first 14 days (or first half) of your cycle, this is before you have ovulated. This phase is dominated by estrogen, a hormone secreted by the ovaries.

• Estrogen is responsible for maturing your follicles (making your eggs grow) AND thickening your uterine lining

• FSH and estrogen work together to support egg maturation

• When estrogeun reaches its peak level, it stimulates the release of more luteinizing hormone (LH). This is the hormone responsible for triggering ovulation

• FSH and estrogen do NOT have a strong thermogenic effect, i.e they do not significantly increase body temperature

LH – THE OVULATION PHASE

• Luteinizing hormone (LH) triggers ovulation when it reaches its peak level

• This is the hormone measured in urine ovulation predictor kits

• LH has very little thermogenic effect, it does not increase body temperature

Quick note: An LH surge does not always reflect an actual egg release from the ovaries, and, in some diagnostic populations such as PCOS, a urinary Luteinizing Hormone test can lead to false positives because this hormone is always elevated

PROGESTERONE – LUTEAL PHASE

• The luteal phase takes place after you have ovulated, and typically lasts 14 days

• This phase is dominated by progesterone, a hormone secreted by the ovaries

• Progesterone is responsible for maintaining your uterine lining, and prevents you from getting a period when you are pregnant by keeping your uterine lining intact

• If you do not become pregnant after ovulation, progesterone levels decrease and you will get a period and shed your uterine lining. If you do become pregnant after ovulation, progesterone levels continue to rise

• Progesterone has a strong thermogenic effect, this means it raises your body temperature

THE MENSTRUAL PHASE

• Progesterone is responsible for maintaining your uterine lining, so when progesterone sharply declines your period will begin

• All of your hormones are at their lowest during the menstrual phase, so you don’t need to pay particular attention to temperature at this time

• An ideal period bleed lasts for 4-5 days and does not cause any pain. A healthy flow requires the changing of a regular absorbency pad or tampon every 4 hours; needing to change more frequently than this is a sign of heavy bleeding, also known as menorrhagia

• It is normal and healthy to spot at the end of your period, but you should not spot for more than 1-2 days before your period. Spotting is considered light, brown bleeding. Bright red blood is considered a peri- od bleed. The first day you notice bright red bleeding is considered cycle day 1.

This is an example of a full cycle from the iFertracker app. The purpose of tracking BBT is to easily and confidently determine when you are ovulating while also capturing a full picture of your reproductive health.

How does it work?

Each night you go to sleep wearing the iFertracker device underneath your arm. It monitors your core temperature continuously throughout the night. Then, in the morning when you wake up, you simply sync the data collected overnight and the algorithm singles out your BBT. At the end of a roughly one month cycle, you will have a completed chart similar to the one above. Your temperature depends on where you are in your cycle. The chart is color coded so that as the thermometer is tracking your temperature you will be able to see if/ when you are ovulating. The yellow bars are warning days from the iFertracker that you are in your fertile window and should start trying to conceive if you’re trying to get pregnant. The orange bar indicates the day of ovulation (surrounded by yellow fertile window bars).

As you can see from the chart above, the temperatures are lower before ovulation day (in orange) and higher after ovulation day. The ovulation day is the LAST low temperature, after this day the temperature rises. In this example, the temperature on ovulation day is 36.3oC (97.34oF), the next 3 days following ovulation are at a temperature of 36.6oC (97.88oF). This means that ovulation occurred. Remember that temperatures are lower before ovulation because of estrogen, and higher after ovulation because of progesterone. If you are pregnant, the temperature will not drop and you will not get a period. In some women the temperature may even rise further, this is the first sign of pregnancy.

You Shouldn’t Use Any Old Thermometer – Here’s why iFertracker makes sense

1. BBT tracking is a hindsight method. You won’t know you have ovulated until the temperatures increase, and once you see the increase ovulation has already passed. The iFertracker algorithm will predict ovulation before it happens, and warn you with yellow colored bars on your chart.

2. True BBT occurs ~2 hours before waking, you can’t take your temperature while you’re asleep unless you’re using the iFertracker! It’s a continuous wearable thermometer, it measures your temperature before you wake up and gathers roughly 20k data points per night.

3. The most annoying thing about traditional BBT tracking is that its not actually BBT tracking; it’s similar and involves taking your temperature every day FIRST thing in the morning, before you move a muscle, but it’s actually gathering “waking temperature”. By only gathering tem- perature once you wake up, you’re completely missing your true BBT. Moreover, you have to wake up at the same time every day to take your oral temperature (aka no cuddling!); you don’t have to do this with the wearable iFertracker.

4. Sometimes you have to wake up in the night to pee or because you’re anxious. Without the iFertracker, you would not be able to test your temperature in the morning as you have to have slept for 3 hours un- interrupted for the temperature to be valid. The iFertracker is able to notice this waking and disregard it from the BBT interpretation.

5. Last but not least, there’s a handy app that does all of the tracking for you! No need for a paper and pencil or data entry into a different app every morning. You have seen an example chart already.

So, Is There More I can learn about my hormones from BBT tracking?? You Bet

Sex hormones control your basal body temperature. If we see trends in your BBT charts that are different than what we expect, this is a clue that your hormones are not acting in the way we expect. Here’s your ultimate BBT cheat sheet for the goal temperatures we want to see:

• Follicular phase (before ovulation): 36.2 – 36.4 C (97.2 – 97.5 F) Ovulatory phase: the temperature needs to increase by at least 0.2 C (0.4 F) the day after ovulation.

• Luteal phase (after ovulation): above 36.7 C (98.0 F)

Let’s look at some examples:

PROGESTERONE DEFICIENCY

This woman ovulated on the day of the orange bar on the far left. Her temperatures increased post ovulation from 36.0oC (96.8oF) to 36.3C (97.34oF). This is a good rise in temperature. However, her luteal temperatures (after ovulation) only reach 36.5oC on one day. This is evidence of a progesterone deficiency because, remember, the ideal temperature is 37oC. Her temperatures do not get high enough, and they fluctuate significantly. This woman may experience premenstrual spotting and infertility.

ESTROGEN EXCESS

The follicular phase of this woman’s cycle is represented between the pink bar on the far left and the orange ovulation bar on the far right. Remember, the follicular phase should last no longer than 14 days before ovulation. As you can see she has a very long follicular phase, lasting 21 days. One reason for this occurrence is that her estrogen level is too high. Her temperatures reflect this, as they rise to 97.9oF (36.6oC) and they shouldn’t be higher than 97.5oF (36.38oC). This is an example of delayed ovulation due to estrogen excess. She may have symptoms of estrogen dominance like breast tenderness and menstrual pain.

ESTROGEN DEFICIENCY

Now we are going to look at a case when there isn’t enough estrogen being produced. This woman has an extremely variable follicular phase temperature, as you can see by the peaks and valleys on the chart. On many days her temperature is below the expected 36.2oC (97.16oF), this is an example of estrogen deficiency. Estrogen deficiency can also cause delayed ovulation, notice that it takes this woman 17 days to ovulate. She may experience symptoms of hot flashes and night sweats due to the irregularity.

Other Natural Ways to Track Ovulation

While you are tracking BBT, you can also use other natural methods to confirm ovulation.

CERVICAL MUCUS

• The cervix secretes fluid throughout the menstrual cycle

• This fluid serves as an aid to fertility, by encouraging the sperm to swim through the cervix when you are ovulating and blocking sperm from entering when you are not ovulating

• Creamy/liquidy – this consistency is most common during the follicular phase and estrogen levels are increasing. It resembles the consistency of lotion or sunscreen and is white in colour

• Clear/ stretchy fluid – ovulatory fluid is transparent and stretchy. It resembles the consistency of a raw egg white. If you place it between your fingers you can stretch it. Have you ever gone to wipe down there and it seems slippery? That is ovulatory fluid you are wiping! Some women get ovulatory fluid for one day, and some for a week. If you see the fluid leading up to, or on the same day that you ovulate according to your BBT, that’s a great confirmatory sign

• Tacky/dry fluid – after you have ovulated the cervix closes. There is no reason for the sperm to enter the uterus as the egg has already been released. You may notice a fluid that resembles the consistency of glue, or you may notice none at all

• Any fluid you see should be white/creamy or clear. If you see a differ- ent fluid, you may have a vaginal infection

CERVICAL POSITION

This one takes some practice and involves you becoming familiar with your vagina!

How to find it

If you insert one finger and feel towards the back of the vagina, your finger will come in contact with a structure that feels like the tip of your nose. That is your cervix

What is it?

The cervix is a structure between the vagina and the uterus. It is the entry point for sperm, and an exit point for a baby

Why is it important?

Your cervix changes position throughout your cycle. It also opens and closes slightly. When you are not ovulating your cervix is closed and will be closer to your finger when you insert it. When you are ovulating your cervix will be open and harder to reach with your finger

What should you do?

Practice finding your cervix during different days of your cycle so that you can become familiar with the open vs. closed position. Practice makes perfect!

Other Ovulatory Symptoms:

• Some women experience increased libido around ovulation

• Some women experience ovulatory cramping, called Mittelschmerz, on the side in which they are ovulating

• Some women notice more acne, breast tenderness, and or bloating around ovulation

• You may not have any of these symptoms and that’s okay too!

What Your Symptoms Are Telling You About Your Hormones

Lab work is great, but sometimes your symptoms (and temperatures) are enough to tell you what might be happening in your body. The following hormonal patterns are usually associated with the following symptoms:

DEFICIENCY Estrogen

• Hot flashes

• Vaginal dryness

• Headaches

• Light periods

• Dry skin

• Hair loss

• Acne

• Decreased libido

• Confusion/ memory changes

• Insomnia

• Weight gain

EXCESS Estrogen/ FSH

• Breast tenderness

• Low appetite

• Fibrocystic breasts

• Painful periods

• Heavy periods

• Mood changes

• Anxiety

• Fluid retention

• PMS

EXCESS Progesterone

• Acne

• Bloating/ water retention Fatigue

• Weight gain

• Anxiety

• PMS

DEFICIENCY Progesterone

• Anxiety

• Low libido

• Mood changes Headaches

• PMS

• Irregular periods

• Premenstrual spotting

• Miscarriage

The presence of each of the symptoms can help you determine which phase of your cycle you’re in, and if you have ovulated. You can track them in the iFertracker app so that you can compare symptom trends and monitor changes in your hormones. It is ideal for you to have no symptoms at all, but it is very rare. Although these symptoms are common, it does not mean they are normal or that you need to suffer with them. Speak with a healthcare professional if you would like more information.

So You’re Not Ovulating on Cycle Day 14: What Does That Mean?

The iFertracker is a non-invasive and reliable way to determine whether your cycles are healthy and optimal for conception. If your BBT chart is not showing signs of ovulation, like you can see in the one below, there may be an underlying cause.

LONG CYCLES

Cycles that last longer than 35 days are long cycles. This is often due to delayed ovulation or complete lack of ovulation. In order for you to get pregnant, you must ovulate. Delayed ovulation is problematic as it is a sign that your ovaries are not responding to hormonal signals from the brain and it is taking the egg too long to mature and is not healthy. Cycles can often get longer in your 30s due to changing hormones.

SHORT CYCLES

Cycles that are shorter than 25 days are short cycles. This is usually due to premature ovulation. Premature ovulation is problematic because your ovaries may be releasing an egg that is not mature and cannot be fertilized. Cycles often get shorter in your 40s due to lower ovarian reserve. This means you have fewer eggs left.

ANOVULATION

This chart is an example of a likely anovulatory cycle (no ovulation). As you can see, the temperatures are consistently within the 36.4 – 36.6 C range. This is too high for the follicular phase, and too low for the luteal phase. There is not enough of a rise to suggest ovulation. With anovulatory cycles there is lots of estrogen, but no progesterone. The lining builds up and this causes spontaneous and irregular bleeding. You may bleed for long periods of time, or multiple times a month, if you are not ovulating. This can happen for a number of reasons, we will only dis- cuss a few of them. If you recognize any of the following in yourself, you should speak with your healthcare practitioner.

PCOS

Also known as Polycystic Ovarian Syndrome. PCOS is caused by insulin resistance and abnormal levels of testosterone. This hormonal pattern prevents ovulation. You may notice symptoms of acne, male pattern hair growth, and weight gain.

HYPERTHYROIDISM & HYPOTHYROIDISM

The first is elevated thyroid hormones and the second is decreased thyroid hormones. Both an increase and decrease in thyroid hormone can impair ovulation, which will prevent you from having a regular period.

HYPOTHALAMIC AMENORRHEA

This is a fancy term for not having a period because you don’t have enough stimulating hormones coming from the brain. The most common reasons for this are stress, low body weight, and extreme athleticism.

FIBROIDS / CYSTS

Fibroids are large masses of tissue in the uterus. Cysts are fluid filled sacs in the ovaries. These growths typically occur under the influence of high levels of estrogen or a nutrient deficiency. Cysts can also produce estrogen themselves. These extra hormones and growths can interfere with ovulation, embryo implantation, and cause heavy bleeding.

Click here to get 10% off iFertracker with code FHH10.